Breaking Up With My Meds

In the fall of 2014 the author decided to quit the prescription medications she has been taking to treat her anxiety, depression and insomnia, and began the process of gradually reducing her dosages. In Going Off, a series of Anxiety posts in the coming weeks, she will chronicle the challenges she faces from both the drugs and the withdrawal in her pursuit of a drug-free life.

My psychiatrist wheels his desk chair toward the couch to show me the graphs he’s holding: One tracks my depression over the course of a year and a half. The other tracks my anxiety over the course of a year and a half. The results are based on surveys he emails me every couple of months that ask me to rate various symptoms of my anxiety and depression on a scale of one through five. It’s November 2014. In the last year and a half, I’ve given my brain every possible rating.

The psychiatric surveys meddled like cold hands, asking me if I wake in the night, but expressing no interest in the details of my slowest, bleakest hours.

In early 2013, I agreed to try medication. I’d been on medication a few times before, but had always quit because it wasn’t working or I couldn’t write, so I was in no rush to return to it. I was seeing a psychotherapist at the time. During one session, while I was crying, despondent, barely communicative because I hadn’t slept well in months, she looked at me and made a window-washing circle in the air to indicate my face. “This,” she said, “is depression.” She told me that we weren’t getting anywhere anymore, that we wouldn’t get anywhere unless I could climb out of this hole, which she didn’t think I could do without meds. “You’re too depressed,” she said, giving me a psychiatrist’s name and phone number. It’s a little embarrassing to be told by your therapist that you’re too depressed, like having a chef tell you before he serves your meal that he’s sorry, but you’re too hungry.

Photo

Credit Yann Kebbi

I went to the psychiatrist, who told me that with medication, we would aim to get my mood as close to 100 percent as possible, my anxiety as close to 0 percent as possible. Reaching perfection would give me the best shot at success when I later weaned off.

The surveys, not unlike the illnesses they gauge, feel like a waste of my time. I resented them most in the beginning, before my antidepressants kicked in, when they meddled like cold hands, asking me if I wake in the night, but expressing no interest in the details of my slowest, bleakest hours. They never asked if I lay in bed with my eyes wide open, imagining being buried, or panicking that everyone I knew hated me because I hadn’t had the energy to return their phone calls. The surveys never asked, “Does your heart pound as if it’s trying to escape?” or, “Why haven’t you checked your voice mail in nine months?” or, “Do you ever feel in a crowd that you’ve never been more alone?” The surveys didn’t care about the time I had a Carole King song loop through my head for a month — even while listening to other music, even while sleeping — or that I fantasized about squeezing my brain in my fist until the song popped like a balloon.

Now, looking at the depression graph, I see that I never reached 100 percent. I briefly hit 90. I’m fairly certain that feeling 100 percent is an urban legend. “I still want to wean off all of it,” I tell my doctor. I’m taking a fairly low dose of everything now: 200 milligrams of bupropion, my antidepressant; 100 milligrams of trazodone, my sleeping pill; and 1 milligram of lorazepam, for anxiety.

“I’m in a tough spot,” he says, wheeling back to his desk, “because meds do help you. And meds are what I have to offer.”

When I reduce, my anxiety and depression creep back in; when I increase, my side effects range from grim to unbearable.

I’m in a tough spot, too. He’s right that I’m one of the lucky ones: Antidepressants make me less depressed and benzodiazepines, with the help of trazodone, calm my anxiety and help me to sleep. Since March 2013, I’ve tried various combinations of drugs, searching for the perfect balance: a stable mood, low anxiety, freedom from insomnia, minimal side effects. But balance, too, is an urban legend. When I reduce, my anxiety and depression creep back in; when I increase, my side effects range from grim to unbearable. Even at my current low doses, my hair is falling out. My thinking is slowed, my creativity stymied. When I work, I feel as though boulders are strapped to my brain. I’m constantly thirsty. I’ve lost my taste for exercise, a mood-enhancer I’ve long relied on, and become more sedentary than I’ve ever been. Perhaps most disruptive of all, depression still lies, dead weight, on top of me — a few hours here, a few hours there — and medicated, I feel less motivation to wriggle out from under it.

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I’m not free from anxiety, either, particularly anxiety over my medication. I worry about the long-term effects of these drugs, which are still relatively new to consumers. I worry about Big Pharma. My stomach clenches when I read about covered-up studies and the ugliest side effects of the very medications pharmaceutical companies hard-sell to psychiatrists, including to pediatric psychiatrists. I feel great discomfort with my doctor’s Celexa clock.

We strike a deal: He’ll help me get off all of my medication if I come in for more appointments, keep in closer contact with him. He recommends a few therapists, too, jotting down their names and numbers on a pad of paper. I doubt I’ll call them. I left therapy a year ago and still enjoy my freedom from it. I’ve tried other alternatives to medication, as well. Yoga. Meditation. A light box. Veganism. Blackout curtains. Fish oil. Quitting alcohol. Quitting caffeine. Nothing has helped as much as meds have. But at this point, I care less about my anxiety and depression worsening, and more about getting back to being me.

Years ago, I had a boyfriend who had two benign cysts removed from his scalp. He kept those cysts in a jar on his bookshelf and liked to show them to house guests. Grotesque as I found those fatty little things, I understood the pleasure he took in them. Stray hair-tweezing gives me comparable satisfaction. Splinter-removal. Pimple-popping. I’m not alone in that: For example, even though we’re told over and over that colonics, detoxes, and prepackaged “cleanses” don’t do much good, that they might even cause harm, they remain as popular as ever — we’re so certain there’s a way to expel excess from the body, to become spotless on the inside. We blow our noses and look at the tissue, perversely enthralled by what we’ve eliminated, by the passageway we’ve cleared. We go to the gym to “sweat it out,” watch tear-jerkers to “cry it out,” endure talk therapy for years, even decades, to identify the source of pain, as if it’s one, immutable contaminant lodged somewhere it shouldn’t be, a pea under a mattress that once found can be removed.

Psychiatric disorders are no pea. Depression and anxiety are diffuse, nebulous, ever-mutating. Pills, on the other hand, are concrete little things — pebbles to pluck from the bottom of a shoe. And that’s my goal — to pluck the pebbles, to get back to basics, to believe in my body as a self-sustaining ecosystem.

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We worry. Nearly one in five Americans suffer from anxiety. For many, it is not a disorder, but a part of the human condition. This series explores how we navigate the worried mind, through essay, art and memoir.